Help! My Child Still isn’t Taling

HELP! MY CHILD
STILL ISN’T
TA L K I N G

Betsy Sylvester, MS, CCC-SLP

TYPICAL
SOUND
DEVEL-
OPMENT

TYPICAL
SPEECH SOUND
PLACEMENT

TYPICAL VOCABULARY DEVELOPMENT

SOUND DEVELOPMENT IN DOWN
SYNDROME

• Greater incidence of phonological processes:

– Final Consonant Deletion
– Stopping
– Voicing errors
– Fronting
– Lateralization
– Syllable

• Errors present for longer
• Greater variability
• Greater inconsistency

VOCABULARY DEVELOPMENT IN
DOWN SYNDROME

Age in months Receptive Sign Verbal

11-15 months 20 words and understands gestures - -

16-20 months 40-60 words 1-2 words -

21-25 months 100-125 words 10-15 words 3-6 words

26-30 months 150-175 words 20-25 words 10-20 words

31-35 months 180-250 words 13-20 words 30-80 words

36-40 months 250-400 words 10-15 words 90-150 words

COMMON CHARACTERISTICS OF SPEECH IN
DOWN SYNDROME

• Low intelligibility
• Dysfluent
• Lower MLU
• Increase in phonological processes
• Decreased generalization

SO WHY IS IT SO
HARD FOR
INDIVIDUALS WITH
DOWN SYNDROME?

PROCESSING TIME

• 10 second wait time
• Visual learners
• Minimal auditory memory
• Short term memory difficulties
• Rapid rate of speaker
• Difficulty with generalization

ORAL MOTOR CONCERNS

•Low tone
•Hypo- or Hyper-sensitivity
•Oral motor therapy: Is it necessary???

DYSFLUENCY

•Higher than normal occurrence of dysfluency.
•Motor planning difficulties
•Perceived incompetence

POSSIBLE MOTOR PLANNING
DIFFICULTIES

• Many individuals with Down syndrome present with motor planning difficulties

– Difficulty finding words
– Difficulty putting words together
– Sound to sound difficulty
– Groping
– Prosody

OTHER CONTRIBUTING FACTORS

• Hearing
• Health
• Anatomical differences
• Limited vocabulary
• Exposure
• Learned helplessness
• Generalization

SO WHAT CAN I
DO???

SIGN LANGUAGE

AUGMENTATIVE
AND ALTERNATIVE
COMMUNICATION
DEVICES

TOTAL
COMMUNICATION
IS THE ANSWER

SPEECH THERAPY
IDEAS AND
TECHNIQUES

HOW TO TREAT MOTOR PLANNING

• Repetition, Repetition, Repetition
• Build syllable shapes (CV,VC, CVC, etc)
• Allow for processing time
• Visual and tactile cues
• Mirror
• Gross motor
• PLAY – Make it fun!

HOW TO TREAT DYSFLUENCY

• Focus on their overall communication. Listen actively. Listen to what they are saying not the way
they are saying it.

• If you miss something, ask for clarification.
• Practice communication etiquette: try not to finish sentences or guess words.
• Refrain from giving advice such as “slow down”,“take a breath”, or “relax”.
• Maintain natural eye contact and body language.
• Speak in a natural, unhurried way. This promotes good communication.
• Talk about Stuttering. It should NEVER be a taboo subject. If you sincerely have a question, the

person will probably appreciate your interest. However, the person who stutters may be sensitive
about their speech.

ARTICULATION THERAPY

• Oral motor therapy
• Placement therapy
• Visuals,Visuals,Visuals
• Tactile Cues
• Generalization

VOCABULARY BUILDING

• Use of visuals

– Matching
– Identifying
– Labeling

• Generalization

– Across materials
– Across people
– Across environments

• Make sure to build a variety of words

– Nouns
– Verbs
– Adjectives

EXPANDING VOCABULARY

• Use consistent vocabulary
• Stay one step ahead of them
• Chunking
• Short phrases with small pauses
• Check for clarification
• Practice when you have time – on topics you are familiar

– Favorite people, toys, places
– Use picture cues
– Carrier phrases

THANK YOU!

IF YOU HAVE ANY QUESTIONS,
PLEASE CONTACT ME AT
[email protected]